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Operation Eye See You. (WINK News photo)
Operation Eye See You. (WINK News photo)

Authorities dismantle large insurance fraud ring with Fort Myers locations

Investigators charged several suspects for setting up fake eye doctor clinics and using stolen identities to collect millions.

Fraud detectives with the Florida Department of Financial Services said, the suspects are part of a large insurance fraud ring with locations in Fort Myers.

Authorities arrested 10 of the 14 suspects. One person is expected to turn themself in Wednesday, but the others are still at large.i

The group is accused of billing United Healthcare and Florida Blue for high-end eye treatments.

The group submitted more than 23,000 claims from 2015-2018 totaling almost $43 million. Just over $10 million was paid out.

The suspects are accused of stealing doctors’ identities and were operating 15 phantom clinics that were nothing more than a storefront. Three of those were in Fort Myers.

The accused “ring leader” is a former Miami doctor with a history of shoddy behavior leading his license to be taken from him.

Another suspect was a former billing manager who knew how to handle the paperwork aspect of the operation and franchised the fake clinics with friends.

Jimmy Patronis, CFO of Florida, said the insurance companies were not the only victims.

“Ultimately, the victim is becoming the citizens of Florida,” Patronis said, “who will see a change in their cost for health insurance rates because of fraudulent billing practice.”

Consumers calling fraud hotlines and reporting suspicious activity on their insurance statements helped authorities make arrests, Petronis said.

The following suspects all face multiple felony charges in connection to this case:

Xiomara Baullosa, 59—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Maylene Cruz, 51—charged with one count of racketeering; 12 counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

· Enrique Galera-Risco, 61—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Sandra Nadal Hidalgo, 58—charged with one count of racketeering; one count of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Anais Hernandez Jorge, 39—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Jorge Valido Leyva, 42—charged with one count of racketeering; one count of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Luis Eslen Machado, 27—charged with one count of racketeering; one count of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Nivardo R. Parra, 52—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Gonzalo Rodriguez, 50—charged with one count of racketeering; four counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Nestor Rodriguez, 60—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Nestor Damian Rodriguez, 28—charged with one count of racketeering; two counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Arnaldo Valido, 30—charged with one count of racketeering; seven counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information;

Jorge Arnaldo Valido, 61—charged with one count of racketeering; 16 counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; and one count of fraudulent use of personal identification information; and

Minerva Valido, 57—charged with one count of racketeering; four counts of fraudulent insurance claim; one count of scheme to defraud; one count of money laundering; one count of fraudulent use of personal identification information.

Reporter:Allison Gormly
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